Therapies that are based on autonomic modulation have shown efficacy in a variety of cardiovascular diseases in both preclinical and clinical studies. The autonomic balance can be modulated to have more parasympathetic tone by stimulating parasympathetic targets or inhibiting sympathetic targets, and can be modulated to have more sympathetic tone by stimulating sympathetic targets or inhibiting parasympathetic targets.
Sympathetic overactivation is involved in a variety of cardiovascular disease, such as ventricular arrhythmias, myocardial infarction (MI), heart failure (HF), etc. For example, vagus nerve stimulation, which generally increases parasympathetic tone, has been proposed as a therapy for cardiovascular problems such as cardiac rhythm management, myocardial infarction and ischemia, heart failure (HF), blood pressure control such as to treat hypertension, and sleep disordered breathing, and also has been proposed as a therapy for epilepsy, depression, pain, migraines, eating disorders/obesity, and movement disorders.
Spinal cord stimulation (SCS) has been proposed to control pain control, such as ischemic pain conditions. SCS has been shown to have a sympatholytic effect. These effects are mediated either directly through modulation of sympathoefferent spinal circuits or indirectly by peripheral vasodilation via spinal-mediated nerve traffic, similar to dorsal root reflexes.